- CVS Health (Harrisburg, PA)
- …And we do it all with heart, each and every day. **Position Summary** The ** Medicare Compliance Consultant** is a compliance role that supports the ... partnership with - and under the direction of - the health plan, Medicare Compliance Officer, and other team members, this position will help develop and… more
- CVS Health (Harrisburg, PA)
- …highly regulated function, this role will also oversee delegated PBM functions, cross Medicare Pharmacy Organizational Compliance with CMS regulations as well as ... implementation and milestone tracking for business plans as Part of the Medicare benefit and product cycle. Directs the strategic development and implementation of… more
- Highmark Health (Harrisburg, PA)
- …A key responsibility is the creation, revision and management of spreadsheets related to Medicare coverage analysis and compliance with Medicare rules and ... Health Network **Job Description :** GENERAL OVERVIEW: Responsible for the Medicare Coverage Analysis (MCA) for sponsored projects within WPAHS, budget development… more
- AmeriHealth Caritas (Philadelphia, PA)
- …managing relationships with independent brokers and general agencies, while ensuring full compliance with Centers for Medicare & Medicaid Services (CMS), state, ... **Role Overview:** The Medicare Broker Relations Manager drives broker channel growth...broker recruitment, engagement, and performance optimization to support overall Medicare sales objectives. **Work Arrangement:** + Remote - Associate… more
- Sedgwick (Philadelphia, PA)
- …and laws + Knowledge of medical terminology for claim evaluation and Medicare compliance + Knowledge of appropriate application for deductibles, sub-limits, ... SIR's, carrier and large deductible programs. + Strong oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Strong organizational skills + Strong interpersonal skills + Good negotiation skills +… more
- US Physical Therapy (York, PA)
- …Previous outpatient orthopedic clinic experience + Exercise and Manual based skills, Medicare compliance responsibilities and Sports Rehab + Outgoing and ... energetic personality **Additional Information** + Great hourly compensation + 401k + Multiple opportunities for Professional Development, Specialization, and Leadership + Family-Friendly Work Environment + Investment from a company that wants you to succeed… more
- Prime Therapeutics (Harrisburg, PA)
- …our passion and drives every decision we make. **Job Posting Title** Mgr Medicare Part D Pharmacy Programs - Remote, Pennsylvania **Job Description** Manages the ... coordination of benefits in the pharmacy program with Medicare Part D plans. Provides the technical and leadership skills that ensure successful Part D pharmacy… more
- Gentiva (Bala Cynwyd, PA)
- …+ **Demonstrated ability to apply hospice principles, industry standards, and regulatory compliance ( Medicare , Medicaid, JCAHO, ACHC)** We are seeking a ... + Demonstrated ability to apply hospice principles, industry standards, and regulatory compliance ( Medicare , Medicaid, JCAHO, ACHC) + Knowledge and compassion… more
- Prime Therapeutics (Harrisburg, PA)
- …analytical skills **Preferred Qualifications** + PBM/health care experience related to Medicare , Medicaid, Commercial, HIM + Certified Compliance and Ethics ... passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Risk Assessment and Oversight) - Remote **Job Description** The Senior… more
- Humana (Harrisburg, PA)
- …service should be authorized. All work occurs with a context of regulatory compliance , and work is assisted by diverse resources which may include national clinical ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more